Atopic dermatitis in children - treatment, causes, symptoms, drugs. Atopic dermatitis, how to treat and whether chronic atopic dermatitis can be cured

Atopic dermatitis in infants is a chronic immune inflammation of the child’s skin, characterized by a certain form of rashes and their staged appearance.

Childhood and infant atopic dermatitis significantly reduces the quality of life of the entire family due to the need for strict adherence to a special therapeutic diet and a hypoallergenic lifestyle.

Main risk factors and causes of atopic dermatitis

A risk factor for atopic disease is often a hereditary history of allergies and. Factors such as constitutional features, nutritional disorders, and insufficiently good care for the child are also unfavorable.

Understanding the pathogenesis of this allergic disease will help you understand what atopic dermatitis is and how to treat it.

Every year, scientists' knowledge about the immunopathological processes occurring in the body during atopic childhood is increasing.

During the course of the disease, the physiological skin barrier is disrupted, Th2 lymphocytes are activated, and immune defense is reduced.

Concept of the skin barrier

Dr. Komarovsky, in his articles popular among young parents, touches on the topic of the characteristics of children's skin.

Komarovsky highlights 3 main features that are important in breaking the skin barrier:

underdevelopment of sweat glands;
fragility of the stratum corneum of the children's epidermis;
high lipid content in the skin of newborns.

All these factors lead to a decrease in the protection of the baby’s skin.

Hereditary predisposition

Atopic dermatitis in infants can occur due to a filaggrin mutation, in which changes occur in the filaggrin protein, which ensures the structural integrity of the skin.

Atopic dermatitis develops in children under one year of age due to a decrease in the local immunity of the skin to the penetration of external allergens: the biosystem of washing powder, the epithelium and hair of pets, fragrances and preservatives contained in cosmetic products.

Antigenic loads in the form of toxicosis in pregnant women, taking medications by a pregnant woman, occupational hazards, highly allergenic food - all this can provoke an exacerbation of an allergic disease in a newborn.

food;
professional;
household

Prevention of allergies in infants can be achieved through natural, long-term, rational use of medications and treatment of diseases of the digestive system.

Classification of atopic dermatitis

Atopic eczema is divided according to age stages into three stages:

infant (from 1 month to 2 years);
children's (from 2 years to 13);
teenage

In newborns, the rash looks like redness with blisters. The bubbles break easily, forming a wet surface. The baby is bothered by itching. Children scratch out rashes.

Bloody purulent crusts form in places. Rashes often appear on the face, thighs, and legs. Doctors call this form of rash exudative.

In some cases, there are no signs of weeping. The rash looks like spots with slight peeling. The scalp and face are most often affected.

At the age of 2, sick children's skin is characterized by increased dryness and cracks appear. The rashes are localized in the knee and elbow pits, on the hands.

This form of the disease has the scientific name “erythematous-squamous form with lichenification.” In the lichenoid form, peeling is observed, mainly in the folds and elbow bends.

Facial skin lesions appear at older ages and are called “atopic face.” Pigmentation of the eyelids and peeling of the skin of the eyelids are observed.

Diagnosis of atopic dermatitis in children

There are criteria for atopic dermatitis, thanks to which the correct diagnosis can be made.

Main criteria:

early onset of the disease in an infant;
itching of the skin, often occurring at night;
chronic continuous course with frequent serious exacerbations;
exudative nature of the rash in newborns and lichenoid in older children;
presence of close relatives suffering from allergic diseases;

Additional criteria:

dry skin;
positive skin tests during allergy testing;
white dermographism;
presence of conjunctivitis;
pigmentation of the periorbital region;
central protrusion of the cornea - keratoconus;
eczematous lesions of the nipples;
strengthening of the skin pattern on the palms.

Laboratory diagnostic measures for severe atopic dermatitis are prescribed by a doctor after examination.

Complications of atopic dermatitis in children

Frequent complications in children include various types of infections. The open wound surface becomes a gateway for Candida fungi.

Prevention of infectious complications consists of following the recommendations of an allergist regarding the specific use of emollients (moisturizers).

List of possible complications of atopic dermatitis:

folliculitis;
boils;
impetigo;
anular stomatitis;
candidiasis of the oral mucosa;
skin candidiasis;
Kaposi's eczema herpetiformis;
molluscum contagiosum;
genital warts.

Traditional treatment of atopic dermatitis

Treatment of atopic dermatitis in children begins with the development of a special hypoallergenic diet.

An allergist prepares a special elimination diet for a mother with atopic dermatitis in her baby. This diet will help you maintain breastfeeding for as long as possible.

An approximate hypoallergenic elimination diet for children under one year of age with atopic dermatitis.

Menu:

breakfast. Dairy-free porridge: rice, buckwheat, oatmeal, butter, tea, bread;
lunch. Fruit puree from pears or apples;
dinner. Vegetable soup with meatballs. Mashed potatoes. Tea. Bread;
afternoon tea Berry jelly with cookies;
dinner. Vegetable and cereal dish. Tea. Bread;
second dinner. Formula or .

The menu for a child, and especially for a child with atopic dermatitis, should not contain spicy, fried, salty foods, seasonings, canned food, fermented cheeses, chocolate, or carbonated drinks. The menu for children with allergic symptoms limits semolina, cottage cheese, sweets, yoghurts with preservatives, chicken, bananas, onions, and garlic.

Mixtures based on it will also help in the treatment of atopic dermatitis in a child.

In case of hypersensitivity to cow's milk proteins, the World Organization of Allergists strongly does not recommend the use of products based on non-hydrolyzed goat's milk protein, since these peptides have a similar antigenic composition.

Vitamin therapy

Patients with atopic dermatitis are not prescribed multivitamin preparations, which are dangerous from the point of view of the development of allergic reactions. Therefore, it is preferable to use single preparations of vitamins - pyridoxine hydrochloride, calcium pathotenate, retinol.

Immunomodulators in the treatment of allergic dermatoses

Immunomodulators that affect the phagocytic component of immunity have proven themselves in the treatment of allergic dermatoses:

Polyoxidonium has a direct effect on monocytes, increases the stability of cell membranes, and is able to reduce the toxic effect of allergens. It is used intramuscularly once a day with an interval of 2 days. A course of up to 15 injections.
Lycopid. Strengthens the activity of phagocytes. Available in 1 mg tablets. May cause an increase in body temperature.
Zinc preparations. They stimulate the restoration of damaged cells, enhance the action of enzymes, and are used for infectious complications. Zincteral is used at a dose of 100 mg three times a day for up to three months.

Hormonal creams and ointments for atopic dermatitis in children

It is not possible to treat severe atopic dermatitis in children without the use of local anti-inflammatory glucocorticosteroid therapy.

For atopic eczema in children, both hormonal creams and various forms of ointments are used.

Below are basic recommendations for the use of hormonal ointments in children:

in case of severe exacerbation, treatment begins with the use of strong hormonal agents - Celestoderma, Cutivate;
to relieve symptoms of dermatitis on the torso and arms in children, the drugs Lokoid, Elokom, Advantan are used;
It is not recommended to use Sinaflan, Fluorocort, Flucinar in pediatric practice due to serious side effects.

Calcineurin blockers

An alternative to hormonal ointments. Can be used on the face and natural folds. The drugs Pimecrolimus and Tacrolimus (Elidel, Protopic) are recommended to be used in a thin layer on the rash.

These drugs should not be used in immunodeficiency states.

The course of treatment is long.

Products with antifungal and antibacterial activity

For infectious uncontrolled complications, it is necessary to use creams containing antifungal and antibacterial components - Triderm, Pimafucort.

The previously used and successful zinc ointment has been replaced by a new, more effective analogue - activated zinc pyrithione, or Skin-cap. The drug can be used in a one-year-old child to treat rashes with infectious complications.

For severe weeping, an aerosol is used.

Dr. Komarovsky writes in his articles that there is no more formidable enemy for a child’s skin than dryness.

Komarovsky advises using moisturizers (emollients) to moisturize the skin and restore the skin barrier.

The Mustela program for children with atopic dermatitis offers a moisturizer in the form of a cream-emulsion.

The Lipikar program of the La Roche-Posay laboratory includes Lipikar balm, which can be applied after hormonal ointments to prevent dry skin.

Treatment of atopic dermatitis with folk remedies

How to cure atopic dermatitis permanently? This is a question that scientists and doctors around the world are asking themselves. The answer to this question has not yet been found. Therefore, many patients are increasingly resorting to homeopathy and traditional methods of traditional medicine.

Treatment with folk remedies sometimes brings good results, but it is better if this method of treatment is combined with traditional therapeutic measures.

When the skin gets wet during a severe exacerbation of allergic dermatosis, folk remedies in the form of a lotion with a decoction of string or oak bark help well. To prepare the decoction, you can purchase a series in filter bags at the pharmacy. Brew in 100 ml of boiled water. Use the resulting decoction to apply lotions to the rash areas three times during the day.

Spa treatment

Most Popular sanatoriums for children with manifestations of atopic dermatitis:

sanatorium named after Semashko, Kislovodsk;
sanatoriums “Rus”, “DiLuch” in Anapa with a dry maritime climate;
Sol-Iletsk;
sanatorium "Klyuchi" Perm region.

limit your child’s contact with all types of allergens as much as possible;
give preference to cotton clothes for your baby;
avoid emotional stress;
Trim your child’s nails short;
the temperature in the living room should be as comfortable as possible;
try to keep the humidity in the child’s room at 40%.

What follows Avoid for atopic dermatitis:

use alcohol-based cosmetics;
wash too often;
use hard washcloths;
take part in sports competitions.

All food products can be divided into 3 groups according to the level of food sensitization. Here is a list of commonly used ones in the diet:

Thus, it is advisable for children at risk of developing atopic dermatitis and mothers during breastfeeding to exclude foods with a high allergenic potential from the menu.

In addition to food sensitization, there can also be polyvalent sensitization, in which there are several reasons for the development of allergies. This can be not only food, but also antibiotic therapy, early transfer to artificial feeding and complementary foods, a family history of atopy, an unfavorable course of pregnancy in the mother (decreased immunity in the baby), diseases of the digestive system in parents, etc.

Basic principles of treatment of atopic dermatitis

Therapy of the disease is aimed at the following goals:

elimination or reduction of itching and inflammatory changes on the skin;
preventing the development of severe forms;
restoration of skin structure and function;
treatment of concomitant pathologies.

All measures necessary for the successful treatment of atopic dermatitis can be divided into 3 groups:

General events

In case of atopic dermatitis, the child or his mother (if the child is breastfeeding) must follow a hypoallergenic diet.

Diet therapy

Features of nutrition of children with atopic dermatitis:

exclusion from the diet of products containing extractive substances (irritate the mucous membrane of the gastrointestinal tract and increase the production of gastric juice): strong broths based on meat and fish, sausages, canned food, marinades and pickles, smoked fish;
absence of strong allergens in the menu: chocolate and cocoa, citrus fruits, mushrooms, nuts, honey, fish products, various seasonings;
if you are allergic to cow protein, it is necessary to use formulas for babies based on soy or goat milk protein, as well as partially hypoallergenic and highly hydrolyzed ones;
for mild and moderate forms of the disease, fermented milk products are useful (they improve the digestion process due to beneficial microflora);
complementary foods in the first year of a child’s life must be introduced with great caution, but at the same time as in healthy children: products should be with the least allergenic activity and first consist of one component (only one type of fruit or vegetable - a monoproduct);
You can expand the menu of an infant gradually: after 3–4 days, add a new ingredient to the diet;
It is better to cook in water with preliminary soaking of finely chopped vegetables for 2 hours (potatoes - 12 hours), it is recommended to use the following products: zucchini, cauliflower and white cabbage, light varieties of pumpkin, potatoes (no more than 20% of the total dish);
porridges are cooked without milk using (corn, buckwheat, rice), because gluten - a protein of cereals, found mainly in semolina and oatmeal, provokes the development of allergies;
(horse meat, rabbit meat, turkey, lean pork, beef, except veal) for complementary feeding is prepared twice (the first water after boiling is drained and the meat is refilled with clean water, after which it is cooked for 1.5–2 hours), broth is not used;
if a slight allergy to a product occurs, it is necessary to exclude it from the diet for a while and introduce it later: if there is no reaction, it can be used in food; if there is, it should be excluded for a long period; in case of severe allergies, the product is replaced with another of equal nutritional value.

Environmental control:

frequent change of the child’s bed linen (2 times a week), exclusion of pillows and blankets made from natural materials (down, feathers, animal hair);
removal of carpets and upholstered furniture from the home to limit contact with dust;
It is advisable to clean the apartment with air humidification (a washing vacuum cleaner or a vacuum cleaner with an aquafilter);
reducing exposure to electromagnetic radiation from computers and TVs;
air conditioning and humidification of the room using climate systems (humidity level 40%);
It is advisable to have a hood in the kitchen; wipe all damp surfaces dry;
absence of animals in the house;
during the period of active flowering of plants outdoors, it is necessary to close all windows in the room (to prevent the entry of pollen and seeds);
Children's clothing made from natural fur should not be used.

Systemic pharmacotherapy:

Antihistamines

Prescribed for severe itching and exacerbation of atopic dermatitis, as well as in emergency cases (urticaria, Quincke's edema). They have a hypnotic effect and can cause dry mucous membranes (in the mouth, nasopharynx), nausea, vomiting, and constipation. These are first generation drugs: Tavegil, Diphenhydramine, Suprastin, Pipolfen, Fenkarol, Peritol, Diazolin, etc. They are characterized by a quick but short-term therapeutic effect (4–6 hours). Long-term use is addictive, it is necessary to change the drug after 2 weeks from the start of use.

Medicines of the 2nd generation do not have a hypnotic effect and do not cause side effects, unlike the 1st generation. Often used in children. Among them: Kestin, Claritin, Lomilan, Loragexal, Claridol, Clarotadine, Astemizole, Fenistil (allowed from 1 month of the baby’s life), etc. The effect of these drugs is long-lasting (up to 24 hours), taken 1-3 times a day. They are not addictive and can be used for quite a long time - from 3-12 months. After discontinuation of the drug, the therapeutic effect lasts for another week. But there is also a disadvantage to this group of drugs: they have cardio- and hepatotoxic effects and are not recommended for people with abnormalities in the functioning of the cardiovascular system and.

Third generation antihistamines are the most favorable for use, especially in childhood. They do not have the unwanted effects described in previous groups. In addition, these drugs are converted into an active chemical compound only when they enter the body (negative effects are reduced). Third generation antihistamines can be used for long-term treatment of any allergic manifestations and can be used from a very early age in children. Among them are the following drugs: Zyrtec, Zodak, Cetrin, Erius, Telfast, Xizal, etc.

Membrane stabilizers

These drugs inhibit the allergic reaction by reducing the production of inflammatory products. They have a preventive effect. Prescribed to prevent relapse of atopic dermatitis. Among them are the following drugs: Nalkrom (used from 1 year of age) and Ketotifen (from 6 months of age).

Drugs that restore the function of the gastrointestinal tract

This group of medicines improves the functioning of the digestive tract and corrects the intestinal biocenosis. With normal functioning of the gastrointestinal tract, the effect of allergens on the body decreases and the frequency of atopic reactions decreases. These drugs include enzymes: Festal, Digestal, Mezim forte, Pancreatin, Panzinorm, Enzistal, etc. In order to normalize the state of the intestinal microflora, prebiotics (Lactusan, Lactofiltrum, Prelax, etc.) and probiotics (Linex, Bifiform, Bifidumbacterin, Acipol, etc.). All medications are taken in courses of 10–14 days.

Medicines that regulate the state of the central nervous system

Increased fatigue and excessive mental stress, nervousness and irritability, stress, long-term depression, and insomnia in children can provoke relapses of atopic dermatitis. To reduce the risk of unwanted exacerbations, medications are prescribed to normalize brain function. Among them are the following: nootropics - substances that stimulate mental activity (Glycine, Pantogam, Glutamic acid, etc.), antidepressants - substances that fight feelings of depression (prescribed only under the supervision of a psychiatrist), sedatives - calming agents (Tenoten for children, Novo -Passit, Persen, children's soothing teas with mint, lemon balm, valerian, etc.), sleeping pills - means to combat insomnia (Phenibut, Bayu-Bai drops, Evening Tale tea, Morpheus drops, etc. etc.) etc.

Immunotropic substances

Prescribed to increase and activate immunity if there are at least 3 symptoms from the list:

the presence of multiple foci of chronic inflammation in the child (caries, adenoids, hypertrophy of the tonsils, etc.);
frequent exacerbations in chronic foci;
sluggish or latent course of exacerbations;
frequent acute (ARVI, acute respiratory infections, ARI, influenza, adenoviral infection, etc.) - 4 or more times a year;
frequent increases in temperature to subfebrile levels (37.–38.5 °C) of unknown origin;
enlargement of different groups of lymph nodes (submandibular, parotid, occipital, axillary, inguinal, etc.) – lymphadenopathy;
lack of an adequate response to treatment for inflammatory diseases.

In cases of existing immunological (secondary) deficiency, the following drugs are prescribed: Taktivin, Timalin, Thymogen.

Vitamins

ß-carotene and pangamic acid (B 15) have the most beneficial effect on the body of an atopic child; thiamine (B 1) is contraindicated - it increases allergies. All vitamins are prescribed in age-specific dosages.

Antibacterial drugs

Prescribed in the presence of bacterial inflammation on the skin (rash with signs of purulent discharge) and fever for more than 5 days. The drugs of choice are: macrolides (Sumamed, Fromilid, Klacid, Rulid, Vilprafen, etc.) and 1st and 2nd generation cephalosporins (Cefazolin, Cefuroxime, etc.).

Antihelminthic drugs

Corticosteroids

Prescribed according to strict indications only in a hospital setting. As a rule, corticosteroids are used in short courses (5–7 days at a dose of 1 mg/kg per day) in severe cases of atopic dermatitis. The drug of choice is prednisolone.

Local treatment

Often takes a leading place in the treatment of atopic dermatitis. Main goals:

suppression of allergic manifestations (itching, redness, swelling) at the site of inflammation;
elimination of dryness and flaking;
prevention or treatment of skin infections (attachment of bacterial or fungal flora);
restoration of the protective function of the dermis - the surface layer of the skin.

Basic products for topical use:

Lotions and wet-dry dressings with medicinal solutions

They are used, as a rule, in the acute phase of the disease. The solutions used include the following: infusion of strong tea, oak bark, bay leaf, Burov's liquid (aluminum acetate 8%), rivanol solution 1:1000 (ethacridine lactate), 1% tannin solution, etc. Lotions or dressings with medicinal liquids have an astringent and anti-inflammatory effect and are prescribed externally to inflammatory lesions (in diluted form).

Dyes

Also prescribed in the acute phase of atopic dermatitis. Among the commonly used are the following: Fukortsin (Castellani paint), 1-2% solution of methylene blue. The dyes have an antiseptic (cauterize) effect and are applied to the affected areas of the skin 2–4 times a day using a cotton swab or cotton swab.

Anti-inflammatory agents (cream, ointment, gel, emulsion, lotion, etc.)

They are usually used in the chronic phase of the disease. Based on the strength of the hormonal effect on the body, there are 4 classes of anti-inflammatory drugs:

weak - Hydrocortisone (ointment);
medium - Betnovate (cream - a dosage form containing oil and water, penetrates to a shallow depth, is used for acute skin inflammation and moderate weeping process; ointment - a dosage form containing the largest amount of fat, penetrates deep into the skin, used for dry lesions and compactions );
strong - Beloderm (cream, ointment), Celestoderm (cream, ointment), Sinaflan (ointment, liniment - a thick dosage form rubbed into the skin for external inflammation), Lokoid (ointment), Advantan (cream, ointment, emulsion - dosage form, containing immiscible liquids, used as a non-greasy ointment, as well as for sunburn and seborrheic dermatitis), Elokom (cream, ointment, lotion - a liquid dosage form containing alcohol and water, used to treat the scalp), Fluorocort (ointment);
very strong – Dermovate (cream, ointment).

All products are used externally 1-2 times a day, applied in a thin layer to the affected areas of the skin (lightly rubbing), the course of treatment is determined by the doctor and the age of the child. It is recommended for infants and young children to use Advantan (from 6 months) and Elokom (from 2 years). They are considered the safest and most effective in treating children. For older age groups, any other anti-inflammatory drugs can be prescribed.

If there is bacterial inflammation on the child’s skin, then use ointments with erythromycin, lincomycin, gel (a soft dosage form that is easily distributed over the surface of the skin and does not clog pores, unlike ointment) Dalatsin, Bactroban ointment and any hormonal ointments containing an antibiotic .

For fungal skin infections, Nizoral (cream) and Clotrimazole (ointment) are used.

There are also non-hormonal anti-inflammatory drugs. They relieve itching and inflammation and are local antiseptics. Treatment will take longer and be less effective. However, you need to know and use these remedies if atopic dermatitis occurs in a mild form, the rash is treatable, an infant or young child, etc. Among them are the following: Fenistil gel, ichthyol ointment, zinc paste and ointment, cream Bepanten plus, etc..

Keratoplasty agents (improve regeneration - healing)

Used in the chronic phase of atopic dermatitis: Solcoseryl ointment, Actovegin, Bepanten and other products with vitamin A (retinol acetate), Radevit. Ointments are applied in a thin layer to the affected areas 1-2 times a day until healing.

Features of skin care for an infant with manifestations of atopic dermatitis

You need to bathe your baby in water without chlorine - dechlorinated, because bleach causes dry skin, increases the inflammatory reaction and itching;
it is necessary to use slightly alkaline soaps and shampoos with a neutral pH acidity level;
It is recommended to add strong tea to the bath until the water turns light brown or a decoction of bay leaves (boil 7–10 bay leaves in 2 liters of water for 5–7 minutes);
if allergic rashes intensify, it is necessary to bathe the baby 3 times a week, and not daily;
You can add decoctions of some herbs to the bath (chamomile, chamomile, anti-allergenic mixture, etc.), but with caution (the herbs themselves can cause a skin reaction);
After bathing the child, you should not dry it with a rough towel, you just need to blot it with a soft diaper, and then treat the affected areas with medications prescribed by a doctor (pediatrician, dermatologist or allergist).

Conclusion

The “Doctor Komarovsky School” program also talks about atopic dermatitis in children:

Any changes in the child’s health status – cause for serious concern on the part of his parents. The appearance of specific rashes on the skin, which are considered to be one of the first signs of atopic dermatitis, is no exception.

The rash gives the baby a lot of unpleasant sensations and affects his mood and general condition. At the same time, atopic dermatitis today is becoming an increasingly common problem.

Thus, in European countries the number of children susceptible to developing the disease varies from 30 to 50% of the total child population. How to treat atopic dermatitis in a child?

You can learn how to recognize inflammation of appendicitis in a child from ours.

general characteristics

In particular, an allergic reaction in most people occurs to 1-2 (rarely more) substances - allergens.

Moreover, even a small amount of this substance is enough for a reaction to occur. If we are talking about atopy, the list allergens that provoke the appearance of a rash are significantly wider. This list may vary depending on the age of the child, environmental conditions, and other factors.

Atopic dermatitis is an inflammatory, allergic reaction of the skin that occurs as a result of a child’s contact with a substance – an allergen.

In the first 3 years of a baby’s life, the disease is considered congenital, since the main reason for its development is hereditary factor. Depending on the age of the baby, there are 3 forms of the disease:

Infant dermatitis occurs in children aged 0-3 years. At this age, manifestations of the disease to one degree or another are observed in 45-60% of children.
Children's Dermatitis develops between the ages of 3 and 7 years in approximately 20% of children.
Teenage the form is considered the rarest.

It is generally accepted that this disease is caused by a high predisposition to the formation of type E immune cells when the body comes into contact with an allergic element (for example, during food intake, skin contact with an irritating substance).

The disease has a wave-like course, that is, periods of exacerbations alternate with temporary improvements in the condition of the little patient.

As a rule, subject to all necessary rules of therapy, over time the disease goes away.

However, there are cases where the symptoms of atopic dermatitis persisted even after the child reached adolescence.

Risk group

There are a number of factors that provoke the development of the disease. First of all, these include hereditary predisposition. So, if allergic manifestations are characteristic of one of the baby’s parents, the risk of inheriting the disease in the child is about 40%.

If both parents suffer from allergies, this figure increases to 80%. The environment in which the child is located also plays an important role.

The development of atopic dermatitis can lead to:

Exists a number of minor factors, the presence of which can provoke the onset of the disease. These include:

passive smoking, that is, inhalation of tobacco smoke when one or both parents smoke in the room where the baby is;
unfavorable environmental situation in the region of his residence;
stress, nervous tension;
seasonal climate changes;
active physical activity, during which sweating increases.

Clinical manifestations

For the presence of atopic dermatitis in a child indicate the following signs:

The appearance of redness on the skin, rash.
Severe itching. Over time, scratches, ulcers, and small wounds appear on the affected areas of the skin. The child experiences severe discomfort, which negatively affects his general condition (poor sleep, lethargy while awake, refusal to feed).
There is a change in the skin, the skin becomes drier, and areas of peeling appear on its surface.
The layers of skin become denser and thicker.

What do the rashes look like?

Atopic dermatitis in a child - photo:

The rash can appear on any part of the child’s body, however, the most common places for the rash to be localized are the face (cheeks), elbows, knees, armpits, buttocks, and scalp.

The nature of the rash may vary. So, individual elements of the rash appear as:

spots (have a red color and irregular shape);
papules (seals on the skin that have a different color from its general surface);
vesicles (rashes in the form of bubbles filled with liquid);
pustules (vesicles filled with purulent contents).

Over time, these elements of the rash can transform into:

peels pustules and vesicles formed at the site of scratching;
plaques when individual affected areas of the skin merge into one;
scarring, areas with lighter or darker pigmentation form when atopic dermatitis becomes chronic.

Possible complications

In the absence of proper and timely treatment of atopic dermatitis, against the background of its development such unpleasant complications may arise How:

Diagnostic methods

To identify the disease, modern doctors use a number of diagnostic methods:

Taking a medical history(assess genetic predisposition, maternal nutritional characteristics during pregnancy and lactation, living conditions of the child and the environmental situation in the region, timing of the introduction of complementary foods, the presence of diseases that can provoke the development of the disease).
Visual inspection patient.
Allergy research. Depending on the stage of the disease, diagnostic methods are different. During the period of remission, a skin test is taken from the patient to assess the condition of the skin. During an exacerbation, the patient takes a blood test to determine the content of immunoglobulin E.
General blood analysis.

Differential diagnosis is also important, that is, measures to distinguish atopic dermatitis from diseases with similar external signs.

Treatment options

How to cure atopic dermatitis in a child? First of all, we should not forget that Only a doctor can prescribe adequate therapy for a child after conducting appropriate research.

Treatment must be comprehensive In particular, the use of medications must be combined with adherence to a proper diet. Numerous traditional medicine recipes will help improve your skin condition.

Medication

Therapy depends on the area of skin damage, the period of the disease, its form, and severity. The age of the young patient is also important. Main groups of medications:

Traditional medicine recipes

The use of folk remedies in combination with basic drug therapy can speed up recovery and achieve faster and more effective results.

The following methods can be used at home:

80 gr. Melt the butter in a water bath, add 30 ml. fresh St. John's wort juice. When the oil thickens again, it will be in the form of an ointment. This ointment should be used to wipe the affected areas of the skin 2 times a day. The course of treatment is until improvement appears;
medium-sized potatoes must be thoroughly washed, peeled, and grated on a fine grater. Place the resulting product on gauze, apply as a compress to the affected areas of the skin for 2-3 hours.

Diet

Proper nutrition - the key to successful recovery.

No therapeutic methods will give the expected result if the patient does not follow the diet prescribed by the doctor.

First of all, it is necessary exclude foods that may cause allergies. These include:

eggs;
nuts;
cereals;
citrus;
cow's milk and products based on it.

Prevention measures

To prevent the development of atopic dermatitis necessary:

Follow nutritional rules and adhere to a healthy lifestyle during pregnancy and lactation.
Breastfeed your baby at least until he reaches 1 year of age.
Choose high-quality, natural food products for introducing complementary foods, avoid dishes containing large amounts of substances - allergens.
Strengthen the child’s immunity, avoid viral and bacterial infections.
Use hypoallergenic products designed specifically for the care of children's skin.
Choose high-quality disposable diapers.
Buy clothes made from natural fabrics.
Maintain hygiene.

Unpleasant manifestations of atopic dermatitis can cause significant discomfort to the child, negatively affect his health.

Moreover, seemingly harmless spots on the skin grow over time, covering more and more new areas of the skin, causing serious complications.

Thus, having noticed the first manifestations of the disease, urgently need to consult a pediatrician.

10 rules for treating atopic dermatitis in this video:

We kindly ask you not to self-medicate. Make an appointment with a doctor!

Dermatitis in children is a local inflammation of the skin due to infection, toxic effects or allergies. Dermatitis in an infant in the form of a rash, crusts, and redness appears on various parts of the body (arms, legs, stomach, back, bottom), causing unpleasant itching, pain and discomfort. The main methods of treating dermatitis are limiting contact with the irritant, using ointments and diet.

External manifestations of dermatitis are easy to recognize if you know what the disease looks like:

Dry skin on the arms and legs, elbows, on the face around the mouth;
Red spots in the groin, buttocks, back and abdomen;
Small blisters with fluid on the legs, arms, face around the mouth, neck, back and buttocks;
Pustules in folds of skin (in the groin) and on open areas of the body (on the face, arms, legs).

Severe dermatitis is complicated by inflammation and swelling, discomfort, and soreness of the skin. After opening the blisters, small wounds form through which the infection penetrates.

Causes

The causes of dermatitis are associated with exposure to an irritating substance on the child's skin. The cause may be a substance that gets on the skin from the environment, then contact dermatitis is called. If a substance first enters the gastrointestinal tract, then into the blood and manifests itself as a reaction on the skin, the disease is called toxicoderma.

Contact

The child may have:

Wet diapers - a rash on the body appears in places of constant contact with the skin, on the back, buttocks, stomach, groin;
Staying in a full diaper causes a rash and redness in the groin, butt and abdomen;
Synthetic clothing and bedding can cause a reaction on the neck, head, and around the mouth;
Unsuitable children's cosmetics cause rashes in those parts of the body where the cream was used: in the groin, on the buttocks, on the cheeks;
Household chemicals are also an irritant; when they come into contact with a baby’s diapers and clothes, they cause rashes on the body.

The rashes on the body become extensive and cause great discomfort. In places where rashes are most common (on the hands and elbows, cheeks and around the mouth), the skin loses elasticity, pigmentation, and becomes thin and vulnerable. If the allergen periodically affects the child, the atypical reaction intensifies.

Treatment for contact dermatitis involves limiting any contact with the irritant.

With proper care, the allergic mood of the body decreases in 80% of children. Signs of dermatitis weaken first on exposed parts of the body (on the face, around the neck, on the back and abdomen, on the legs), and then in closed areas (in the groin, on the arms, and buttocks).

Toxicoderma

Causes of toxicoderma:

Food allergens are the most common cause of facial dermatitis in infants;
Inhalation of exhaust gases (when traveling along roads);
Medicines (often vitamins and cause allergic reactions);
Infectious diseases (form so-called infectious dermatitis in young children).

The disease is also called. The age of the child most susceptible to rashes is up to 3 years. At this age, signs of the disease (rash and redness on the face, around the mouth, in the groin) appear much more often.

Kinds

Dermatitis is divided into the following types:

(aka allergic);
(fungal);
(occurs due to contact with urine and feces).

All types of the disease have characteristic symptoms and it is difficult to confuse them.

Atopic

Atopic dermatitis is an allergic reaction on the skin of a child. Symptoms of atypical dermatitis can be seen on the face, cheeks, back, arms and legs of an infant. In children, a characteristic rash appears on the skin, most often on the face and around the mouth.

Blood tests show an increase in IgE, indicating a widespread allergic reaction.

Atopic dermatitis constantly recurs - it worsens in the winter, and in the summer there is a period of remission. Treatment of allergic dermatitis is based on mandatory diet and the use of antihistamines.

Seborrheic

Seborrheic dermatitis is a fungal infection of the skin of a child. The causes of seborrheic dermatitis are due to the activity of opportunistic Malassezia fungi. Yeast-like fungi live on the skin, feeding on fatty acids from sebum.

If the sebaceous glands do not function correctly, intensely secreting secretions, the fungi begin to multiply rapidly. This is how seborrheic dermatitis occurs - inflammation of the skin, peeling and severe itching. Seborrheic eczema is located on the scalp, most often on the temples and forehead.

Diaper

Diaper dermatitis is an inflammation of the groin, buttocks and lower back where wet diapers adhere closely to the skin. Even with careful care, urine and feces irritate the baby's skin, causing the characteristic symptoms of dermatitis.

Diaper dermatitis most often affects newborns and infants. The rash is located on the butt, groin, legs and abdomen. With age, the problem appears less and less often, and after giving up diapers in favor of a potty, it will disappear completely.

Treatment

To cure dermatitis or reduce its symptoms on any part of the body (elbows, back, scalp in the hair and around the mouth), you must adhere to the following rules:

Avoiding contact between the child and the irritant (gentle diet, control of household chemicals, natural clothing);
External treatment is carried out with antiseptic dressings (medicinal ointment, special cream), folk remedies (herbal baths and rubbing infusions) help.
Internal treatment consists of taking antiseptics and medications to reduce the allergic reaction.
Medicines to improve intestinal function (bifidobacteria), calcium containing vitamin complexes, and a healthy diet (natural products without additives) help.

Means for the treatment of dermatitis (pharmaceuticals and medications, external ointment and cream) must be combined with diet and prevention of contact with the irritant.

Diet and nutrition

A hypoallergenic diet is necessarily included in the complex therapy of dermatitis, especially atypical ones, since the cause of diathesis is food products. Foods that cause allergies should be excluded from the diet of a child under 3 years of age and a nursing mother.

A child on a diet should not be given:

Milk and fermented milk products;
Bird eggs;
Vegetables, fruits and red berries;
Citrus;
Fatty meats and fish;
Smoked meats and pickles;
Chocolate;
Nuts.

When introducing complementary foods, give the baby a teaspoon a day of each new product, observing the reaction. Following a diet for dermatitis relieves the allergenic load on the baby’s body and helps prevent relapses.

Antiseptic cream, medicinal ointments, wipe the rash with disinfecting solutions, herbal infusions.

What creams can be applied:

For weeping atopic eczema, steroid and antihistamine ointments will help;
Seborrhea should be treated with antifungal creams;
For diaper rash, dry the skin with solutions of potassium permanganate and apply moisturizing creams.

Bathe your baby daily in a decoction of chamomile and string, you can wash it with a weak solution of potassium permanganate 2-3 times a day to dry irritated skin.

Prevention

It is impossible to cure dermatitis in children in one day. Sometimes treatment for dermatitis takes several years.

Ointment and cream can only relieve the symptoms of the disease. The best remedy for food rash is constant monitoring of the menu of mother and baby, the use of creams to combat allergic reactions and diaper rash, and the prevention of infection and acute skin inflammation. With the strengthening of the body and the formation of intestinal microflora, the rashes on the hands and head disappear.

Atopic dermatitis in children is an inflammatory disease provoked by allergic reactions to certain etiological factors. It is popularly called “diathesis”. In most cases, it has a chronic course and is quite often accompanied by other pathologies. Diagnosed in 60% of children in the first year of life.

Etiology

It should be noted that atopic dermatitis is almost always diagnosed in a child with a genetic predisposition to allergic diseases. If both parents have allergies, the risk of progression of atopic dermatitis in the child is about 80%. If diseases of this kind occur in only one of the parents, the risk of developing atopy in the child is about 40%.

The etiological reasons for the development of this pathological process in a child include the following:

food allergies;
the period of bearing a child was quite difficult;
poor nutrition of the mother during pregnancy and breastfeeding;
background ailments of the gastrointestinal tract;
seasonal weather changes, unsuitable climate for the child’s body;
presence of bad habits in parents.

As for background ailments that can provoke the development of atopic dermatitis in children, this includes the following:

Allergic etiology should be highlighted separately. The disease can be caused not only by food allergens, but also by household allergens. This may include the following:

some baby care products (wet wipes, creams, shampoos);
powders, fabric softeners;
household chemicals;
inhalation type irritants.

It should also be understood that the progression of the disease in a child can be caused by several etiological factors simultaneously. The more such “connections”, the more complex the form of the disease.

It should be noted that the infant form of the disease requires only complex treatment, with the involvement of medical specialists of various profiles - a dermatologist, gastroenterologist, psychoneurologist, allergist.

Classification

In official medicine, it is customary to distinguish the atopic form of the disease in a child according to the age group:

infant (from 0 to 3 years);
children's (from 3 to 7 years);
teenage (from 7 to 15 years).

Symptoms

Atopic dermatitis in infants can manifest itself in the form of the following symptoms:

severe itching;
skin hyperemia;
formation of cracks at the site of redness;
rashes on the face, in places where the skin bends;
baby's restlessness, poor sleep;
almost complete lack of appetite.

Clinicians note that in more complex cases, the child’s temperature may rise to 38 degrees.

The rashes characteristic of this pathology are localized in the following places:

bends of limbs;
scalp;
ears, cheeks, chin.

The atopic form of dermatitis in a child aged six months to 3 years manifests itself in the form of the following symptoms:

skin redness;
swelling of the skin;
formation of pityriasis scales;
excessive peeling of the affected areas of the skin;
weight loss;
increased skin dryness;
formation of compactions (in places).

Elements of the rash are localized in the following places:

skin on the face;
mucous membrane of the airways;
elbows, feet;
neck area.

For children over three years of age, the following symptoms of progression of atopic dermatitis are typical:

increased dryness of the skin with the formation of scales that visually resemble bran;
redness of the skin;
the formation of cracks in places where the skin folds.

In some cases, the rash progresses to the stage of formation of crusts, which gradually dry out and fall off. It should also be noted that for all age categories, with the development of this pathological process, sudden weight loss and an almost complete lack of appetite are characteristic.

Clinicians note that in rare clinical cases, at the initial stage of development of the disease, symptoms may be absent. In addition, many parents, when the symptoms described above appear, do not seek medical help in a timely manner, trying to eliminate the symptoms through folk remedies.

This form of the disease has a seasonal nature of manifestation - in the summer there are practically no symptoms, while in winter there is an exacerbation.

Stages of development

Clinicians distinguish four stages of progression of atopic dermatitis in a child:

initial – the most striking manifestation of the clinical picture;
severe - transition of the disease from acute to chronic form;
remission - symptoms disappear partially or completely;
period of clinical recovery - symptoms of the disease do not appear for 3–7 years.

Diagnostics

In newborns, the initial manifestation of atopic dermatitis is similar to a simple allergy to food or household factors. This is why many parents do not seek medical help in a timely manner.

At the first manifestations of the above-described clinical picture in a child, you should seek medical help. The doctor will conduct a personal examination, find out your medical history and prescribe additional tests. The standard diagnostic program includes the following:

test for the presence of allergen in the blood;
drip skin test;
prick test.

Using these diagnostic methods, the doctor can not only accurately make a diagnosis, but also establish the cause of the development of the pathological process and prescribe the correct treatment. It is unacceptable to treat a child on your own, using folk remedies. Such arbitrariness can lead to the development of complications.

Therapeutic measures

Treatment of atopic dermatitis in children includes not only drug therapy, but also a proper nutrition regimen. It should be noted that the diet for atopic dermatitis in children should be followed almost always, not only during the period of treatment.

The standard treatment program includes the following activities:

taking antihistamines and antibiotics;
immunomodulatory therapy;
taking vitamins;
physiotherapy;
diet therapy.

In some cases, atopic dermatitis in newborns or a child of older preschool age can be treated using non-drug therapy:

exclusion from the environment of allergic factors;
proper nutrition;
use of traditional medicine (only as prescribed by a doctor).

The disease can be treated in this way only if there are no associated complications.

Drug treatment involves taking the following drugs:

dermatol and furatsilin ointment;
antiseptic solution - hydrogen peroxide, miramistin, fucorcin;
glucocorticoids;
non-hormonal antihistamines.

The doctor may also prescribe special ointments that improve tissue regeneration and trophism.

Diet

It is not advisable to treat such a disease with medications alone, since in many cases the cause of the pathological process is food allergy. Therefore, it is very important to review the child’s nutrition. If we are talking about a newborn, then you should pay attention to the mother’s nutrition.

During the treatment period, you should adhere to the diet prescribed by your doctor. The allergy-provoking product is completely excluded from the diet of the baby and the mother. The introduction of complementary foods should be carried out gradually, in small portions.

As for formulas and baby food, only hypoallergenic products should be used. The introduction of a new food product into a child’s diet must be agreed with a doctor.

The use of folk remedies for such a disease is unacceptable, since it is impossible to establish the true cause of the development of the pathological process without diagnosis.

Folk remedies

You can use traditional medicine only as prescribed by a doctor. As a rule, folk remedies help well only in tandem with basic drug treatment.

Folk remedies for atopic dermatitis are presented in the form of herbal decoction baths, which have antiseptic and soothing properties. However, it is better to use such traditional medicine after consulting a doctor. This is due to the fact that the child may also be allergic to the product itself.

Clinicians note that in most cases, it is traditional medicine using herbs or other home-made remedies that significantly aggravate the situation. Therefore, you should not treat your child yourself.

Prevention

Preventive measures to prevent atopic dermatitis in a child include the following procedures:

exclusion of all allergens;
washing children's underwear and clothes only using anti-allergenic powder and separately from adult clothes;
using only proven baby skin care products;
gradual introduction of complementary foods in small portions;
systematic consultations with a pediatrician and allergist.

At the first manifestations of the clinical picture, you should immediately seek medical help and not try folk remedies.

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